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Künstliche Intelligenz und Smartphone-Programm-Applikationen (Apps)

Bedeutung für die dermatologische Praxis

Artificial intelligence and smartphone program applications (Apps)

Relevance for dermatological practice

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Zusammenfassung

Vorteile der künstlichen Intelligenz (KI)

Durch einen verantwortungsvollen, sicheren und erfolgreichen Einsatz der künstlichen Intelligenz (KI) im dermato-onkologischen Bereich können mögliche Vorteile entstehen: (1) die ärztlich-medizinische Arbeit kann sich auf Hautkrebspatienten fokussieren, (2) Patienten können rascher und effizienter versorgt werden bei zunehmender Hautkrebsinzidenz und parallel abnehmenden Zahlen beruflich aktiver Hautarzte, und (3) Anwender können von den KI-Ergebnissen lernen.

Potenzielle Nachteile und Gefahren des KI-Einsatzes

(1) Ein mangelndes Vertrauensverhältnis bei fehlendem Patienten-Arzt-Kontakt kann sich entwickeln, (2) ein zusätzlicher zeitlicher Aufwand kann durch die zeitnahe ärztliche Kontrolle von der KI als benigne eingestuften Hautläsionen entstehen, (3) ausreichende ärztliche Erfahrungen zum Erkennen und korrigieren fehlerhafter KI-Entscheidungen können fehlen, und (4) bei fehlerhafter KI-Entscheidung ist eine erneute Kontaktaufnahme zum Patienten zur zeitnahen Vorstellung notwendig. Ungeklärt sind bisher bei der KI-Anwendung die medizinisch-rechtliche Situation sowie die finanzielle Vergütung. Apps mit KI erbringen auf Basis von klinischen Bildern von Hauttumoren aktuell keine ausreichende diagnostische Hilfe.

Voraussetzungen und möglicher Nutzen von Smartphone-Programm-Applikationen

Smartphone-Programm-Applikationen (Apps) können verantwortungsvoll erfolgreich eingesetzt werden, wenn die Bildqualität gut ist, anamnestische Angaben unkompliziert eingegeben werden können, die Bild- und Befundübermittlung gesichert ist und medizinrechtliche sowie finanzielle Fragen geklärt sind. Apps können als krankheitsspezifisches Informationsmaterial eingesetzt werden und in der Teledermatologie die Patientenversorgung optimieren.

Abstract

Advantages of artificial intelligence (AI)

With responsible, safe and successful use of artificial intelligence (AI), possible advantages in the field of dermato-oncology include the following: (1) medical work can focus on skin cancer patients, (2) patients can be more quickly and effectively treated despite the increasing incidence of skin cancer and the decreasing number of actively working dermatologists and (3) users can learn from the AI results.

Potential disadvantages and risks of AI use

(1) Lack of mutual trust can develop due to the decreased patient–physician contact, (2) additional time effort will be necessary to promptly evaluate the AI-classified benign lesions, (3) lack of adequate medical experience to recognize misclassified AI decisions and (4) recontacting a patient in due time in the case of incorrect AI classifications. Still problematic in the use of AI are the medicolegal situation and remuneration. Apps using AI currently cannot provide sufficient assistance based on clinical images of skin cancer.

Requirements and possible use of smartphone program applications

Smartphone program applications (apps) can be implemented responsibly when the image quality is good, the patient’s history can be entered easily, transmission of the image and results are assured and medicolegal aspects as well as remuneration are clarified. Apps can be used for disease-specific information material and can optimize patient care by using teledermatology.

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Authors and Affiliations

  1. Hautarzt- und Lehrpraxis, Augustinerplatz 7, 78462, Konstanz, Deutschland

    A. Blum M.Sc. DermPrevOncol

  2. Hautarztpraxis, Ludwigsburg, Deutschland

    S. Bosch

  3. Universitäts-Hautklinik Heidelberg, Heidelberg, Deutschland

    H. A. Haenssle & C. Fink

  4. Universitätsklinik für Dermatologie, Medizinische Universität Graz, Graz, Österreich

    R. Hofmann-Wellenhof

  5. Dermatology Clinic, University Hospital of Trieste, Hospital Maggiore, Trieste, Italien

    I. Zalaudek

  6. Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich

    H. Kittler & P. Tschandl

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Correspondence to A. Blum M.Sc. DermPrevOncol.

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Interessenkonflikt

A. Blum erhielt Vortragshonorare und Reisekostenerstattungen von Almirall Hermal GmbH, Dermatologische Fortbildungsgesellschaft (DERFO), Heine Optotechnik GmbH, HealthCert, JuDerm im BVDD, FotoFinder Systems GmbH, La Roche Posay und MELAsciences Incorporation. H. Haenssle erhielt Honorare und Reisekostenerstattungen von Jenlab GmbH, Heine Optotechnik GmbH, Scibase AB, FotoFinder Systems GmbH, Magnosco GmbH und MELAsciences Incorporation. C. Fink erhielt Vortragshonorare und Reisekostenerstattungen von Almirall Hermal GmbH und Magnosco GmbH. R. Hofmann-Wellenhof ist Gründer und Teilhaber der teledermatologischen Firma e‑derm-consult GesmbH und erhielt Vortraghonorare von Fotofinder GesmbH. I. Zalaudek erhielt Referentenhonorare oder Kostenerstattung als passiver Teilnehmer: Honorar: Novartis Oncology and Immunology, Sanofi Genzyme Oncology, Sun Pharma. Kostenerstattung: Pierre Fabre, Roche Oncology. – Bezahlter Berater/interner Schulungsreferent/Gehaltsempfänger o. Ä.: Berater: Heine Optotechnik GmbH, FotoFinder Systems GmbH, Novartis Oncology, Sanofi Genzyme Oncology. H. Kittler erhielt Referentenhonorare von Almirall Hermal GmbH, Eli Lilly, La Roche Posay und Pelpharma und Unterstützung über Bereitstellung von Hard- oder Software von Derma Medical, Heine Optotechnik GmbH, Fotofinder Systems GmbH und 3Gen. P. Tschandl hat von MetaOptima Technology Inc. 2017 eine einjährige Post-Doc-Forschungsfinanzierung erhalten. S. Bosch gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Aufgrund der besseren Lesbarkeit wurde auf eine genderkonforme Schreibweise verzichtet.

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Blum, A., Bosch, S., Haenssle, H.A. et al. Künstliche Intelligenz und Smartphone-Programm-Applikationen (Apps). Hautarzt 71, 691–698 (2020). https://doi.org/10.1007/s00105-020-04658-4

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